For years as she worked for both Intermountain Healthcare and HCA, Allison Robbins wondered why any large employer would be willing to accept the same medical insurance reimbursements on claims as a smaller one. After all, most large companies have very stringent purchasing guideline (as in the bottom line) for everything else they buy.

That gave her an idea, which led to the creation of Imagine Health, Inc., in 2008. Robbins utilized her experience in the industry with her expertise in provider contracting and negotiations to create a company that has helped reduce medical insurance costs for corporations and their employees.

“If these companies had come to me directly, I certainly would have contracted with them, probably at a rate more appropriate for the deals we’d strike,” she says. “I knew that their purchasing power would be better, like it is for any other product they purchase. So when I made the decision to leave HCA and strike out in a new direction, I began working at home, out of my kitchen. I took a few consulting jobs to see how that would work out, and it blossomed into Imagine Health.”

Back then, the concept was definitely leading edge. In many ways, it still is. Among her first clients was Toyota.

“They wanted to contract directly for their healthcare insurance,” she recalls. “They didn’t want to be like any other automaker. I was lucky enough to be the architect behind designing this network. It caught the attention of other large employers and insurance companies. It helped drive their thinking about how we might solve this healthcare cost issue.”

Robbins says the concept of contracting for services was considered an innovation, but adds that some industries, such as the railroads, have been doing it for decades.

“It was just more rare, and not much thought of as the solution for large companies to help with their insurance costs,” she says.

Imagine Health identifies top-notch hospitals and physicians. The company has criteria for those providers to meet. “We also look at efficient use of healthcare dollars, and we’ve probably boiled it down to maybe 25 percent of the marketplace,” she says. “Because they are so heavily fixed-cost driven—the more patients they can see, the more money they make. So they can make more money at a lower cost because of volume. It’s like an airline or hotel—and can be lucrative for them with the number of patients they treat.”

Though starting with larger companies was easier in the beginning, as “they were ready and willing to innovate,” the program Robbins has created is also available to smaller employers. “For smaller mid-market employers that are self-funded, we can help them gain access to these same networks,” she says.

Ultimately, Imagine Health’s goal is to help transform the healthcare insurance industry. Robbins’ business has continued to grow, as has her workforce. She doesn’t see anything changing drastically under the Trump administration, though “there will always be a bell curve of performance—highs, lows and in between. Regardless of what the environment looks like today, we should be leveraging our purchasing power and our ability to make those decisions. It helps companies and their employees, as proper healthcare allows employees to get back to work quicker and costs them and their companies considerably less.”